{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:44:22Z","timestamp":1790232262990,"version":"4.1.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T00:00:00Z","timestamp":1620000000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T00:00:00Z","timestamp":1620000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","award":["ViiV GSK 209995"],"award-info":[{"award-number":["ViiV GSK 209995"]}],"id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["AIDS Res Ther"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Dolutegravir (DTG) monotherapy results in virologic failure and the development of DTG resistance. Here, we evaluated virologic outcomes of patients switched to DTG functional mono- or dual therapy with a non-cytosine nucleoside analog (NA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, single center study included treatment-experienced patients switched to regimens containing \u2265\u20092 antiretrovirals between 8\/13\/13\u201311\/22\/14 who were later found to be on DTG functional mono- or dual therapy with a non-cytosine NA based on historical genotypes. Eligible patients were either suppressed or viremic at baseline and had \u2265\u20092 HIV-1 RNA measurements at least 4\u00a0weeks apart following switch. Demographics, laboratory values and clinical parameters were extracted from the charts of all eligible patients during study treatment until 12\/31\/2018 and were summarized using descriptive statistics. The primary endpoint was the proportion of patients with HIV-1 RNA\u2009&lt;\u200950 copies\/mL following switch.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 70 patients switched to DTG functional mono- or dual therapy, 39 were eligible; 19 (49%) were on DTG functional monotherapy and 20 (51%) were on DTG functional dual therapy with a non-cytosine NA. Historical genotypes indicated that all had an M184V\/I, and 23 (59%) had an M184V\/I and \u2265\u20091 additional NA mutation. The median duration of follow-up on study treatment was 50\u00a0weeks (range 12\u2013244). Following switch, 32\/39 (82%) patients achieved or maintained an HIV-1 RNA\u2009&lt;\u200950 copies\/mL and 7 (18%) had persistent HIV-1 RNA\u2009\u2265\u200950 copies\/mL. Five viremic patients were found to be on functional dual therapy with DTG plus a non-cytosine NA and 2 were on DTG functional monotherapy. Five of these patients had post-switch genotypes ordered as a part of routine clinical care and there was no evidence of treatment-emergent resistance. Five were switched to a different DTG-containing regimen and achieved HIV-1 RNA\u2009&lt;\u200950 copies\/mL, 1 was switched to a non-DTG containing regimen and achieved HIV-1 RNA\u2009&lt;\u200950 copies\/mL and 1 was lost-to-follow up at week 36.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this real-world cohort, the majority of whom had virus with the M184V\/I and \u2265\u20091 additional NA mutation, switching to DTG functional mono-or dual therapy with a non-cytosine NA resulted in persistent HIV-1 RNA\u2009\u2265\u200950 copies\/mL in 18%. None with post-switch genotypes developed treatment-emergent resistance.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12981-021-00352-0","type":"journal-article","created":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T12:37:14Z","timestamp":1620045434000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Virologic outcomes of switching to dolutegravir functional mono- or dual therapy with a non-cytosine nucleoside analog: a retrospective study of treatment-experienced, patients living with HIV"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6444-2225","authenticated-orcid":false,"given":"Charlotte-Paige","family":"Rolle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vu","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Hinestrosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"DeJesus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"key":"352_CR1","doi-asserted-by":"crossref","unstructured":"Cahn P, Madero JS, Arribas JR, Antinori A, Ortiz R, et al. Durable efficacy of dolutegravir (DTG) plus lamivudine (3TC) in antiretroviral treatment\u2013naive adults with HIV-1 infection\u20143-year results from the gemini studies. Poster P018. HIV Drug Therapy Glasgow 2020; October 5\u20138, 2020, Virtual.","DOI":"10.1016\/j.jiph.2020.01.118"},{"key":"352_CR2","doi-asserted-by":"crossref","unstructured":"van Wyk J, Ajana F, Bisshop F, De Wit S, Osiyemi O, et al. Switching to DTG\/3TC fixed-dose combination (FDC) is non-inferior to continuing a TAF-based regimen (TBR) in maintaining virologic suppression through 96 weeks (Tango study). Oral O441. HIV Drug Therapy Glasgow 2020; October 5\u20138, 2020, Virtual.","DOI":"10.1016\/j.jiph.2020.01.117"},{"issue":"10123","key":"352_CR3","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/S0140-6736(17)33095-7","volume":"391","author":"JM Llibre","year":"2018","unstructured":"Llibre JM, et al. Efficacy, safety, and tolerability of dolutegravir-rilpivirine for the maintenance of virological suppression in adults with HIV-1: phase 3, randomised, non-inferiority SWORD-1 and SWORD-2 studies. Lancet. 2018;391(10123):839\u201349.","journal-title":"Lancet"},{"issue":"3","key":"352_CR4","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/QAI.0000000000002449","volume":"85","author":"J van Wyk","year":"2020","unstructured":"van Wyk J, et al. Brief report: durable suppression and low rate of virologic failure 3 years after switch to dolutegravir + rilpivirine 2-drug regimen: 148-week results from the SWORD-1 and SWORD-2 randomized clinical trials. J Acquir Immune Defic Syndr. 2020;85(3):325\u201330.","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"12","key":"352_CR5","doi-asserted-by":"crossref","first-page":"e547","DOI":"10.1016\/S2352-3018(17)30152-2","volume":"4","author":"I Wijting","year":"2017","unstructured":"Wijting I, et al. Dolutegravir as maintenance monotherapy for HIV (DOMONO): a phase 2, randomised non-inferiority trial. Lancet HIV. 2017;4(12):e547\u201354.","journal-title":"Lancet HIV"},{"issue":"7","key":"352_CR6","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1093\/jac\/dky093","volume":"73","author":"JL Blanco","year":"2018","unstructured":"Blanco JL, et al. Dolutegravir-based maintenance monotherapy versus dual therapy with lamivudine: a planned 24 week analysis of the DOLAM randomized clinical trial. J Antimicrob Chemother. 2018;73(7):1965\u201371.","journal-title":"J Antimicrob Chemother"},{"issue":"9","key":"352_CR7","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1093\/cid\/ciy1132","volume":"69","author":"L Hocqueloux","year":"2019","unstructured":"Hocqueloux L, et al. Dolutegravir monotherapy versus dolutegravir\/abacavir\/lamivudine for virologically suppressed people living with chronic human immunodeficiency virus infection: the randomized noninferiority MONotherapy of TiviCAY trial. Clin Infect Dis. 2019;69(9):1498\u2013505.","journal-title":"Clin Infect Dis"},{"issue":"1","key":"352_CR8","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1089\/aid.2019.0171","volume":"36","author":"M Boffito","year":"2020","unstructured":"Boffito M, et al. Perspectives on the barrier to resistance for dolutegravir + lamivudine, a two-drug antiretroviral therapy for HIV-1 infection. AIDS Res Hum Retrovir. 2020;36(1):13\u20138.","journal-title":"AIDS Res Hum Retrovir"},{"key":"352_CR9","unstructured":"World Health Organization (WHO). Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV. Interim guidelines. 2018. https:\/\/www.who.int\/publications\/i\/item\/WHO-CDS-HIV-18.51."},{"issue":"12","key":"352_CR10","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1097\/QAD.0000000000001845","volume":"32","author":"M Vitoria","year":"2018","unstructured":"Vitoria M, et al. The transition to dolutegravir and other new antiretrovirals in low-income and middle-income countries: what are the issues? AIDS. 2018;32(12):1551\u201361.","journal-title":"AIDS"},{"key":"352_CR11","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2020.0242","author":"V Kouamou","year":"2021","unstructured":"Kouamou V, et al. Pretreatment HIV drug resistance among adults initiating or re-initiating first-line antiretroviral therapy in Zimbabwe: fast-tracking the transition to dolutegravir-based first-line regimens? 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Global epidemiology of drug resistance after failure of WHO recommended first-line regimens for adult HIV-1 infection: a multicentre retrospective cohort study. Lancet Infect Dis. 2016;16(5):565\u201375.","journal-title":"Lancet Infect Dis"},{"issue":"7","key":"352_CR15","doi-asserted-by":"crossref","first-page":"e200","DOI":"10.1093\/cid\/ciaa313","volume":"71","author":"A Borghetti","year":"2020","unstructured":"Borghetti A, et al. Shall we dance? Extending TANGO\u2019s results to clinical practice. Clin Infect Dis. 2020;71(7):e200\u20131.","journal-title":"Clin Infect Dis"},{"issue":"6","key":"352_CR16","doi-asserted-by":"crossref","first-page":"ofy113","DOI":"10.1093\/ofid\/ofy113","volume":"5","author":"R Gagliardini","year":"2018","unstructured":"Gagliardini R, et al. Impact of the M184V resistance mutation on virological efficacy and durability of lamivudine-based dual antiretroviral regimens as maintenance therapy in individuals with suppressed HIV-1 RNA: a cohort study. 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Dolutegravir versus ritonavir-boosted lopinavir both with dual nucleoside reverse transcriptase inhibitor therapy in adults with HIV-1 infection in whom first-line therapy has failed (DAWNING): an open-label, non-inferiority, phase 3b trial. Lancet Infect Dis. 2019;19(3):253\u201364.","journal-title":"Lancet Infect Dis"},{"key":"352_CR22","unstructured":"Santoro MM, Armenia D, Teyssou E, Santos JR, Charpentier C, et al. Impact of M184V on the virological efficacy of switch to 3TC\/DTG in Real Life. Abstract 429. CROI 2021. Virtual, March 6\u201310, 2021."},{"key":"352_CR23","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.ijid.2021.03.018","volume":"105","author":"E Ndashimye","year":"2021","unstructured":"Ndashimye E, Arts EJ. Dolutegravir response in antiretroviral therapy naive and experienced patients with M184V\/I: impact in low-and middle-income settings. 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Antivir Res. 2019;172:104635.","journal-title":"Antivir Res"},{"issue":"11","key":"352_CR26","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1097\/QAD.0b013e3281532ca7","volume":"21","author":"AA Benzie","year":"2007","unstructured":"Benzie AA, et al. Increased duration of viral suppression is associated with lower viral rebound rates in patients with previous treatment failures. AIDS. 2007;21(11):1423\u201330.","journal-title":"AIDS"}],"container-title":["AIDS Research and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12981-021-00352-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12981-021-00352-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12981-021-00352-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T06:43:49Z","timestamp":1672037029000},"score":1,"resource":{"primary":{"URL":"https:\/\/aidsrestherapy.biomedcentral.com\/articles\/10.1186\/s12981-021-00352-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,3]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["352"],"URL":"https:\/\/doi.org\/10.1186\/s12981-021-00352-0","relation":{},"ISSN":["1742-6405"],"issn-type":[{"value":"1742-6405","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,3]]},"assertion":[{"value":"8 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This retrospective study utilized data collected as a part of routine clinical care. The Sterling Institutional Review Board (IRB) determined that the study met IRB exemption criteria based on the retrospective nature of the study (Sterling IRB ID 7115) and participant consent was therefore not required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors of the manuscript have read and agreed to its content and are accountable for all aspects of the accuracy and integrity of the manuscript in accordance with ICMJE criteria.The article is original, has not already been published in a journal, and is not currently under consideration by another journal.All authors agree to the terms of the BioMed Central Copyright and License Agreement, and the Open Data policy.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"There are no competing interests for any of the authors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"26"}}